One Moment, and Everything Changes

 

One Moment, And Everything Changes

We tend to think that our life unfolds in slow, steady chapters — years of plans, habits built one day at a time, milestones we see coming to fruition. But more often than not, it comes down to this: one call, one diagnosis, one decision, or one action. Just one, and everything changes.

About 3 years ago, my life was moving along its familiar path — until one moment, 27 months ago, rewrote my entire story. That was when I received news of my liver failure. In an instant, all the ordinary worries and my hopes of daily life faded away, to be replaced by one urgent and painful question and uncertainty: What matters most now?

Three months later came the decision that gave me a second chance: a great doctor and her team of doctors, a call from SGH at 3 a.m. in the morning, and a liver transplant. That single procedure, and the courage and generosity of those who made it possible (the family of the deceased donor), opened a new chapter — but it was not the end of the journey. Ten months ago, another blow arrived: my body rejecting the new liver. A liver biopsy. Once again, everything shifted. Every choice, every dose, every consultation became critical.

The medication that saved my transplanted liver brought its own hard truth: it led to my chronic kidney disease, now at stage 3b. Then, just as I was finding my footing again, my bile duct constriction surface, and my consistent gradual weight loss of 1 kg per month. A sudden alarm. CT scan of full body, colonoscopy, thyroid function test, ultrasound of thyroid, and a diagnosis: 3.1 cm Level 5 solid nodule in my left thyroid. Prognosis: thyroid cancer.

Each time, it was never a slow, predictable turn. It was a single moment — a test result, a doctor’s voice, a choice to keep going — that divided life into before and after.

I share this not to talk only of the constant adjustment and struggle, but of what these sudden turns teach us: that is, we hold far less control over the timeline than we imagine. What we can choose is how we walk through the changes. We can choose gratitude for every day we are given, care for the body that carries us, and love for the people who stand beside us through every "one moment" that comes our way.

Life does not always follow the script we write. But in every twist, in every new diagnosis, and every hard-won reprieve, there is still a life and story worth living — one day, one choice, one breath at a time.

A Letter of Gratitude for Dr Chanda Ho

Dear Dr. Chanda Ho,

I am writing to you with a heart filled with gratitude—gratitude that I once thought I would never have the chance to express.

On the 8th of May 2024, about 20 months ago, I was transferred from CGH to SGH with a failed liver. I was then just a shadow of myself and at the edge of my life—physically broken, mentally lost, and spiritually defeated.

Physically, I was immobile. I could not even stand up on my own. I was languishing in bed, sleeping most of the time, unable to care for myself, and wearing diapers. I was completely stripped of the dignity that I once had—helpless, weak, and reduced to a version of myself whom I never thought I would become.

Mentally, I had severe memory loss. I was dementia-like, and everyone thought so. My mind had become a fog of confusion and disorientation. I couldn’t follow conversations, couldn’t recognize the faces of those trying to care and help me, and couldn’t hold onto memories. The doctors who examined me saw dementia. I was awake without awareness. At times, I was delirious, and at times, suspicious and paranoid. My family saw me slipping away. And I had given up hope entirely. I was suicidal, ready to surrender to whatever fate awaited me.

That is the version of me when you saw me on 8 May 2024. You were the first doctor from the SGH Liver Team to see me that day. At that time, I cannot remember who saw me, I cannot remember faces, and I do not know what happened during that period until early April 2025, when traces of my fractured memories started coming back to me slowly with plenty of blank spaces. And, through my wife and daughter, and a bedside journal maintained by my wife on my behalf, I got a glimpse of how my days were like, the fear, the words spoken, and the decisions made, that would determine my fate.

While I lay there in my fog of despair, unaware of the battle being fought for my life, you looked at my distressed, lost, and traumatized wife and daughter, and you firmly and decisively told them and me - "You are only 67 years old. Still young. Go for the transplant." Those words were a lifeline. At a time when they see me fading away, and I had already given up on myself, you were there speaking to them with clarity when everything around them was chaos. Your word feels like a verdict to them, like someone switching on a light in a dark room. Not because the danger has disappeared, but because there was a direction. A path. A reason to keep going. You did not see me as a "gone case" patient with liver failure, but a human whose life was still worth fighting for.

You told them that you would put me on the transplant workup immediately so that I could be placed on the waiting list for a matching deceased-donor liver. You acted and followed up with urgency and speed. I learnt from my wife that I was difficult during the workup. I was uncooperative, resistant, and insisted on giving up on the painful workup. But, you and your team of doctors pushed me on knowing the state of my mind - lost, confused, and unable to judge. For example, in my journal record, when I insisted on giving up my workup midway, Dr Thinesh Lee spoke to my wife and daughter in my presence immediately. I recalled Dr Thinesh's words to all of us - "If you stop your workup now, you will not live beyond 2024." And, during this pre-transplant period, there was another doctor in your team who came to my wife and daughter when they were lost, stressed and exhausted. She was Dr Samantha Koh. She was a beacon of lights to my wife and daughter during that period.

In the end, I completed my workup and was quickly placed on the waiting list for a donor liver.

On July 11, 2024—barely two months later—I received a deceased donor liver. And today, the first day of 2026, I am alive to write this letter, alive to understand what my wife and daughter had gone through, alive to feel the full weight of your role, and alive to feel gratitude with a clear mind.

I want to thank you for your decisive actions, judgement, and seeing a life worth saving when I could not see it myself.

I am alive today because of you. My wife still has her husband. My daughter still has her father. My 6 years old grand daughter still has her grandfather. And I have been given the precious gift of more time—time to remember, to hope, and to be grateful. And to see my wife being well, my daughter completing her PhD and started her work as a Professor of Practice at  Singapore University of Technology and Design, and to see my grand daughter going from kindergarten to Primary 1 in RGPS tomorrow. All of which I have never thought I could live to see.

There are no words adequate enough for me to express what you have done for me and my family. You have left an indelible mark on our lives. You are not just a doctor to us—you are the reason I have a future. I will always remember you, and will always be grateful to you.

With deepest gratitude and profound respect,

Ding Ting Hock

1 January 2026

Thank You, Nurses at Ward 45A

 

Thank You Nurses of Ward 45A SGH

Dear Nurses of Ward 45A,

I am writing to express my heartfelt appreciation and thankfulness for the exceptional care I received during my stay from 14 to 24th October (with the first 3 days in Observation Area). Having been hospitalised on numerous occasions, I can confidently say that Ward 45A stands up as the best.

The kindness, attentiveness and efficiency of each nurse made a difference in my recovery. I was also impressed with the quality of the room and the delicious meals provided. 

Thank you from the bottom of my heart to Joey, Evelyn, Sara, Yong Xin, Jia Yin, Bryan, Shahira, Sean, Farhana, Vanessa, Raj, Robert, Jun Hong, Fayu, Eileen, Jie Ying, Amiroon, Maricel, Miranda, Chantel, Khin, Saleh, Daniel, Nora, and others, whom I may have missed when I was sleeping or away for tests, for all your hard work and dedication.

Sincerely,

Ding Ting Hock 

Ward 45A Room 2

31 October 2025

My Thoughts and Reflection on My Liver and Kidney Conditions

This is a record of my medical challenges from

10 to 24 October -> 30 October -> 5 November -> 12 November 2025.

After a liver panel test done on the 13th of October, my results showed signs of liver rejection. This was alerted by my keen-eyed medical coordinator, Beverly. She consulted Dr. Terrence Tan, whom I came to see as a competent and conscientious doctor, who quickly assessed and followed up on my situation. I was immediately told by Beverly that Dr. Terrence advised me to report to the A&E immediately for admission.

I reported to the SGH A&E one day later on 14 October. This event kicks off a series of processes in my mind—observation of my symptoms; assessments and evaluations of my medical conditions; interpretations and understanding of what the test data means; gathering my thoughts after the interpretations; and finally reflecting and musing on the analysis and its implications.

In the first 2 to 3 weeks of October, my results show that my liver was struggling to perform, and there was a parallel deterioration of my kidney function. It suggests the possibility of a rejection or medication toxicity.

My liver/kidney trend from 10 October to 12 November 2025 is as follows:

1. Liver Trend

From the liver panel test done on the 13th of Oct, my liver enzymes (ALT, AST, GGT, ALP, and bilirubin) reveal the following:

• 10 Oct to mid-Oct: 
• ALT and AST were very high (≈160–180), bilirubin was also up, and GGT was high. All these numbers painted a picture of liver inflammation.
• Late Oct (23–29 Oct): 
• ALT/AST dropped drastically (into the 70s / 50–60s range). With bilirubin coming down close to normal. The ALP stayed in the normal range. But GGT stayed high (around 110–140).
• 5 Nov to 12 Nov:
• ALT: 71 → 70 (no change, only mildly above normal).
• AST: 60 → 57 (stable, but mildly high).
• ALP: 89 → 82 (in the normal range).
• Bilirubin: 37 → 41 (mildly high but much better than that of early October).
• GGT: 154 → 178 (still high and creeping up).

As for the production of vital blood proteins like albumin and blood clotting factors, the albumin & total protein seem a bit low but stable and slightly better (TP 63→68, albumin 32→34).

• INR/PT is in a safe range and not drifting up.

• Platelets: low (65 on 10 Oct) but have been rising slowly by late Oct. It was 87 on 12 Nov.

Overall, I could see a big improvement in my liver condition as compared to that of early October. Right now, it is a mild and stable enzyme elevation. Based on the 12 Nov test results, there is no sign of a new sudden rejection. The main abnormality is the persistently high GGT, which may reflect bile-duct irritation or medications.

2. Kidney Trend

Date	Urea (mmol/L)	Creatinine (µmol/L)	eGFR (mL/min/1.73 m²)	Bicarbonate
10 Oct	7.0	111	58	28.8
29 Oct	10.5	129	48	28
5 Nov	12.7	126	50	–
12 Nov	12.7	126	50	26.9

My kidney numbers are as follows:

• From 10 Oct to late Oct, there was a worsening in my kidney functions. My creatinine rose from 111 to 129, eGFR fell from 58 to the high 40s, and urea went up.

• From late Oct → 5 Nov → 12 Nov, the values are fairly stable (creatinine ~125–130, eGFR ~50, urea ~12–13).

• Bicarbonate has stayed normal, which is reassuring.

Overall, for my kidney, I could see that I am sitting on CKD stage 3a, with a mild decline compared with 10 Oct, but there is no rapid deterioration over the last 2–3 weeks. This pattern is consistent with chronic, stable kidney impairment, likely caused by tacrolimus, rather than an acute crisis.

3. Summary

• Liver: The liver panel readings, in particular the enzymes, show improvement from a significant flare in early October. Right now, my liver has stabilized with mild abnormalities, and the graft function overall looks reasonably good. However, a persistent high GGT that needs ongoing follow-up but no obvious new damage between 5 and 12 Nov.

• Kidneys: The later results from the kidney panel, compared with that of 10 Oct, quite clearly show that my kidney function is deteriorating. But from late Oct through 12 Nov, the numbers look stable rather than steadily falling.

Put it simply, for now, based on my lab test results, my liver recovery looks encouraging, and my kidney function, while reduced, appears stable over the last few weeks—not in free fall.

Afternote: I went for my liver team appointment on the 13th of November. The team was led by Dr. Thinesh. In his review of my lab results, he indicated that my FK level appears high at 8.6 (not at trough level) when my prescribed Advagraf is at a low of 1 mg. He asked whether I mistakenly took my Advagraf before the test. I assured him that I took my Advagraf after my blood test, and I have a daily log to show.

He also mentioned the possibility of an ongoing virus during the period. And has followed up with another round of blood tests (11 tubes) on the same day.

Thank You Dr Terrence Tan, Dr George Goh, and the Liver Team

Dear Dr. Terrence Tan, Dr. George Goh, and the Liver Team,

I hope this letter finds both of you and your team of doctors and staff well. I'm writing to express my sincere gratitude for the exceptional care I received during a particularly challenging time. I especially feel a pang of regret for not having taken Dr. Terrence's advice to come in on 13 October, when my condition worsened, resulting in a day's delay for my treatment.

From the moment I reported at the A&E on the late evening of 14 October, Dr. Terrence, your presence was a constant source of reassurance. Seeing you every morning at 9 am, leading the liver team, gave me a sense of stability and confidence that I desperately needed. I truly appreciate the thoroughness with which you approached my case, from the ultrasound on 15 October to rule out liver connection issues to the scan results on 16 October and all those blood tests! I also want to thank you for arranging the biopsy so quickly on 16 October and having my liver samples sent to the investigation team on the same evening to ensure that the outcome of the biopsy results be expedited by 17 October. This level of dedication is truly above and beyond, and it meant everything to me. Thanks to your swift action, my treatment started as soon as possible. You show that you are clearly in charge right from the start on 13 October. I knew I was in good hands when I saw how competent, conscientious, and tenacious you were in your approach to my "liver rejection".

To Dr George Goh - I met you for the first time together with the liver team on 20 October. Thank you for your prompt and timely intervention on 20 October (Monday) when you noticed that my kidney creatinine level climbed from 99 to 127. The high creatinine level suggests that my kidney function is deteriorating very quickly. You reviewed my kidney issues by immediately putting me on a 24-hour plasma drip to address my hydration issue. For the next 2 days, while the new medications had brought my liver out of the woods, my creatinine level continued to climb up to 131 and 145 respectively. You decisively adjusted my Batrium and then my Acyclovir in the next 2 days in a cool, calm, and collected manner. By 23 October, my creatinine level came tumbling down to 124 with my liver continuing to improve. I am grateful for your competent, professional, and decisive actions. You throw my anxiety out of the windows with your “calm under resolute” approach. Thank you.

To the liver team - Dr Ong, Dr Stephanie, Dr Tan, Beverly, Jessie, Gaya, and Rocky - Your dedication, expertise, and genuine care have made an enormous difference in my challenging journey. While this paragraph may be short, it carries with it my most profound gratefulness for everything you've done. Thank you all from the bottom of my heart.

With warmest regards,

Ding Ting Hock 

A Letter of Thanksgiving

Dear Family of St Hilda’s Church, Vicar Martin, and Pastor Amy,

As I lie here in my bed at home after eleven challenging days in hospital, my heart overflows with gratitude that I must express in words.

First and foremost, I give praise and thanks to God for His mercy and faithfulness. While living with a transplanted liver and damaged kidney, I have learned to lean heavily on His grace. During my recent medical crisis, when all my test results had gone awry, I felt His presence sustaining me. The improvement shown through my treatment and new medications is nothing short of His healing hand at work. “The Lord is my strength and my shield; my heart trusts in him, and he helps me” (Psalm 28:7) – these words have never felt more true.

To my dear church family at St. Hilda’s, your prayers have been a lifeline. Throughout the eleven days of emergency treatment, I felt lifted up by your prayers. Knowing that you were standing with me gave me courage when my body was weak. Thank you.

To Vicar Martin, your prayers for my recovery have meant more than words can express. Your spiritual leadership and care for my soul, especially during my medical crisis have been a tremendous blessing. Thank you for shepherding me with such compassion.

To Pastor Amy, I am deeply moved by your visit to my hospital bed to pray for me personally. In that vulnerable moment, when I was undergoing treatment and uncertainty, you brought the peace of Christ’s presence into my room. Your presence, to me was a profound comfort, and I will never forget your coming to pray for me when I needed it most.

The beautiful fruit-flower arrangement you sent speaks of life, hope, and beauty – It is now a daily reminder of your love and God’s goodness.

Though my journey continues, I know that I am surrounded by God’s love expressed through all of you. May His Shalom peace be upon you as it has been upon me, and may He bless you abundantly for the blessing you have been to me.

With deepest gratitude,

Ding Ting Hock 

“Give thanks to the Lord, for he is good; his love endures forever.” (Psalm 107:1)

SWOT Analysis of my Latest Medical Condition

This is my second personal SWOT analysis of my current medical condition. I did my first analysis in May based on the results of my liver test results. This second one is based on the results of my kidney test done yesterday on 10 October.

Over the past few months, I have been closely monitoring my post-liver transplant recovery and my kidney function, which has shown signs of deterioration. My most recent blood test on 10 October indicated that my creatinine level had risen to 111 µmol/L and my CKD-EPI eGFR had fallen to 58, compared to 102 µmol/L and 64, respectively, from four weeks earlier. This decline suggests that my kidneys may be deteriorating faster than expected. I have since alerted my liver team, and they have scheduled a repeat test and a review of my FK (tacrolimus) level to determine whether my Advagraf dose can be reduced to lessen the impact on my kidneys.

To better understand my current condition and identify what I should do next, I have chosen to apply a SWOT analysis—a tool commonly used in business—to my medical situation. This helps me to see not only what is happening medically to me, but also how my personal strengths and circumstances can influence my recovery.

Strengths—One of my greatest strengths lies in my being resilient and my commitment to follow medical advice from my medical team. I have made it a point to take my medications punctually, maintain a liver- and kidney-friendly diet, and stay hydrated with around two liters of water daily. I also have strong family support, especially in managing meals and helping me to stick to my dietary restrictions. I monitor my condition carefully and promptly alert my liver transplant coordinators whenever I notice changes, as I did with the recent kidney test results. My being attentive has allowed my medical team to respond quickly. These strengths form the foundation of my recovery despite the challenges.

Weaknesses—At the same time, I face a number of ongoing weaknesses. Insomnia continues to disrupt my sleep, leaving me with about five hours of total sleep in short segments across the day. I often feel drowsy and fatigued and experience blurred vision and weakened legs, which may be linked to my medications or my declining kidney function. The anti-rejection drug (Advagraf), which is essential for protecting my transplanted liver, is now contributing to kidney damage, creating a difficult trade-off between two vital organs. My mobility has lately been affected too, and my physical stamina is lower than before. All these weaknesses have limited my independence and sense of normalcy.

Opportunities— Despite these setbacks, I see opportunities in my hope for a meaningful recovery. Because I am under the care of a highly competent and coordinated team of specialists in SGH who work closely together on liver and kidney functions. The upcoming retesting and FK level assessment on the coming Monday may allow for a dose adjustment that can spare my kidneys while keeping my liver safe. With advances in post-transplant care, it can offer hope for newer, more kidney-friendly immunosuppressants or supportive treatments. On my part, I can further make an effort to improve areas such as rest quality, strength, and energy management. Most importantly, I believe this is still an early stage of kidney decline, and timely medical intervention can make a real difference.

Threats—However, my current situation also carries significant threats. The most pressing is the potential for rapid kidney deterioration if my current medication levels remain unchanged. The side effects—tiredness, dizziness, weakness, and blurred vision—already impact my daily functioning and could worsen. Managing the delicate balance between liver protection and kidney preservation is medically complex, requiring precise adjustments. Beyond the physical issues, there is also the emotional strain of coping with chronic fatigue and uncertainty, which could affect my mental well-being. Finally, being immunocompromised means I remain vulnerable to infections and other complications that could further burden my health.

The conclusion from my SWOT analysis is that it has helped me to view my medical condition with clarity and structure. It reveals that while the threats and weaknesses are real and serious, they are counterbalanced by my strong internal strengths—discipline, awareness, and family support—and by external opportunities such as expert medical care and evolving treatment options. The key lies in how to leverage my strengths and opportunities to mitigate the risks (coming from the weaknesses and threats) ahead.

In practical terms, this would mean maintaining close communication with my liver transplant coordinators and doctors, continuing my disciplined routines, and staying open to adjustments in treatment or lifestyle that protect both my liver and kidneys. My journey after transplant remains challenging, but it is not without hope. With proper and timely management of my changes, close medical consultation with my medical team, and my resilience, I believe I can continue to navigate this recovery journey towards a more balanced and stable situation.